Kornimate/medical-research-clean huggingface dataset:
direct anterior approach versus mini posterior approach versous lateral approach for displaced femoral neck fractures

Conditions: Hip Fractures; Femoral Neck Fractures

Summary: in general, hip fractures in the elderly are associated with a high one year-mortality up to 36 %. apart from choosing the proper treatment, optimizing the surgical technique itself offers options to improve the outcome. early mobilization after hip hemi¬arthroplasty correlates with improved ambulation, reduced need for assisted transfers, and less use of extended care facilities after hospital discharge. nowadays, in order to reduce soft tissue damage and gain quicker postoperative recovery and faster rehabilitation, various mis techniques have been proposed. two of these techniques are the mini posterior approach and the mini direct anterior approach. the direct anterior approach was developed as a true internervous and intermuscular surgical approach with proposed benefits of faster recovery, quicker return to function, and less pain. in theory, the direct anterior approach should cause less tissue damage than mini posterior approach, as it is performed through a plane between neurlogical tissue and intermuscular plane without muscle transection. the aim of this study is to evaluate the clinical and radiological outcomes of the direct anterior approach for bipolar head endoprosthetic hemiarthroplasty in patients with displaced femoral neck fractures in comparison with the mini posterior approach and the traditional lateral approach, for the treatment of the same fractures. the investigators hypothesized that patients undergoing the direct anterior approach would have better clinical and radiological results in comparison with the mini posterior and lateral approach.


Eligibility criteria:
inclusion criteria: * consecutive patients undergoing hip fracture surgery for displaced femoral neck fractures (garden 3 and 4 fractures) and treated by cemented hemiarthroplasty will be included in the study. patients must have the ability to give informed consent or a legal guardian is available. exclusion criteria: * the exclusion criteria include open or pathological fractures, re-fractures, infection, concomitant injuries of the ipsi- or contralateral leg or upper limb, skin diseases in the area of proposed incisions, patients that are mentally incapable of understanding the consequences of the study and reduced compliance.

Keywords: hip fractures surgical approach outcome bleeding
air-impingement manipulation to clear subglottic secretion compared with drainage tube in prolonged intubated patients

Conditions: Ventilator Associated Pneumonia

Summary: this is a randomized controlled trial compared two methods to drainage subglottic secretion in prolonged intubated patients.after enrolled, patients are randomized assigned to intermittent subglottic secretion drainage group and air-impingement manipulation group.

ventilator-associated pneumonia (vap) is the most frequent infection occurring in patients who are admitted to the icu. the accumulation of respiratory secretions in the subglottic space is a well-proven cause of vap. therefore, prevention should include the aspiration of secretions from the subglottic space. investigators invented a manual method with high-flow air produced by resuscitator to impinge secretion from the subglottic space to oral cavity. this method has been granted as a patent by chinese national intellectual property patent office, it has been used in investigators' daily work for more than 10 years and more than 20 chinese icus have used it everyday. investigators want to compare it with conventional method which uses a special intubation tube with an independent dorsal lumen to suction subglottic secretion.

Eligibility criteria:
inclusion criteria: should meet all the criteria: 1. intubation less than 24 hours before admitting respiratory intensive care unit; 2. anticipated intubation for more than 72 hours; 3. anticipated survival time is more than 2 weeks exclusion criteria: meet any of these criteria: 1. peep≥10cmh2o or fio2≥0.8; 2. unstable hemodynamics; 3. severe bulla and pneumothorax; 4. enrolled in other study; 5. cuff leak test is positive.

Keywords: ventilator associated pneumonia subglottic secretion drainage manual air-impingement operation prolonged intubation
armassist robotic device for arm training

Conditions: Hemiparesis

Summary: armassist is low cost simply robotic devise for arm training and assessment. it is suitable for extended home rehabilitation and prolonged hospital rehabilitation without therapist supervision. the device contains several games which are structured as exercise for disabled patients. the primary aim of this study is to correlate efficacy of the arm training with armassist robot system to conventional care modified by duration and structure of exercise. the secondary aim of this study is to measure the correlation between standard clinical assessment scales and armassist-based assessment metrics.


Eligibility criteria:
inclusion criteria: * unilateral paresis; * ability to understand and follow simple instructions; * minimum ability to perform active movements, even though trunk compensation, using the shoulder and/or the elbow joints. exclusion criteria: * bilateral impairment; * severe sensory deficits in the paretic upper limb; * cognitive impairment or behavioral dysfunction that would influence the ability to understand or perform the experiment; * inability to provide informed consent; * other current severe medical problems.
the desensitising effect of nanosilver fluoride in molar-incisor hypomineralisation

Conditions: Molar Incisor Hypomineralization; Hypersensitivity

Summary: the aim of the current study is to assess the desensitising effect of nanosilver fluoride on first permanent molars (fpms) in patients with mih in comparison to low-level laser therapy.


Eligibility criteria:
inclusion criteria: * the presence of at least one hypersensitive first permanent molar in mih patient (using the schiff cold air sensitivity scale (scass)). * completion of an informed consent to participate in the study. exclusion criteria: * hypomineralised molars resulting from other medical conditions, such as enamel malformations associated with syndromes, dental fluorosis, enamel hypoplasia, amelogenesis imperfecta, and dental caries. * the presence of active tooth decay or defective restorations in the tooth under examination which can confound the aetiology of hypersensitivity with pulpitis. * the presence of pulpal symptoms. * having undergone any professional desensitising treatment in the previous 6 months. * having used a desensitising paste other than habitual toothpaste in the previous 3 months. * use of anti-inflammatory drugs or analgesics at the time of recruitment. * allergy or sensitivity to silver or any of the materials included in the study.

Keywords: nanosilver fluoride low-level laser therapy desensitising molar-incisor hypomineralisation first permanent molars pediatric clinical trial nanosilver lllt
a clinical trial to evaluate the efficacy and safety of mxp22 on liver health

Conditions: Non-Alcoholic Fatty Liver Disease

Summary: a randomized, double blind, placebo controlled clinical trial to evaluate the efficacy and safety of mxp22 on liver health


Eligibility criteria:
inclusion criteria: 1. adult men and women aged more than equal to 30 and less than or equal to 60 years, diagnosed with nafld within last 2 years. 2. cap scores more than equal to 248 and less than or equal to 270 db/m indicating steatosis grade i/ ii. 3. non-alcoholics (little or no consumption of alcohol). 4. willing to participate in the study with a signed and dated written consent. 5. overweight and obese participant with bmi more than or equal to 25 kg/m2. 6. having at least 3 of the following five metabolic risk factors: i waist circumference: men: more than or equal to102 cm (40.15 inches); women more than or equal to 88 cm (34.65 inches). ii triglycerides \>150 mg/dl. iii blood pressure more than or equal to 130 mm hg (systolic, sbp) and/or more than or equal to 85 mm hg (diastolic, dbp). iv fasting blood glucose more than or equal to 100 mg/ dl. v low hdl level: men: \< 40 mg/dl; women: \< 50 mg/dl. exclusion criteria: 1. treatment of nafld for at least 3 months prior to the screening. 2. history of decompensated liver disease (ascites, encephalopathy, variceal bleeding). 3. participants with liver cirrhosis, any concomitant liver disease. 4. participants with systemic inflammatory disease or autoimmune disorders. 5. participants with blood pressure less than or equal to 160 mm hg (systolic, sbp) and/or less than or equal to 95 mm hg (diastolic, dbp). 6. participants with fasting blood glucose less than or equal to 140 mg/ dl. 7. participants with cardiopulmonary disease. 8. heavy alcohol drinkers defined as follows: i for men, consuming more than 4 drinks on any day or more than 14 drinks/week ii for women, consuming more than 3 drinks on any day or more than 7 drinks/week 9. participants with liver cancer - primary hepatocellular carcinoma or liver metastasis. 10. participants with other systemic disorders of the heart, lungs, blood, and endocrine system, including thyroid dysfunction and type i diabetes mellitus. 11. histologic evidence of nash with fibrosis stage (metavir score) f1 or f4. 12. individuals with inflammatory bowel diseases. 13. use of medications containing systemic steroids, methotrexate corticosteroids, amiodarone, tamoxifen, valproate, vitamin e, omega-3, anti-retroviral agents; 1 month prior to screening. 14. intake of probiotics (lactic acid bacteria, etc.), prebiotics (dietary fiber, fructooligo saccharide, etc.), new biotics, fermented milk and proton pump inhibitor within one month before screening or during the study period. 15. participants who have hypersensitivity to the test drug/ placebo or components contained in the test drug/placebo or have severe allergic reactions. 16. females who are breast-feeding, lactating, pregnant or intending to become pregnant. 17. regular use of a probiotic or prebiotic supplement within 3 months prior to screening. 18. antibiotic use within 3 weeks prior to screening.
an open-label, phase 1/2 trial of gene therapy 4d-310 in adults with fabry disease

Conditions: Fabry Disease

Summary: this is a prospective multicenter, open-label, dose-escalation trial to assess the safety, tolerability, and pharmacodynamics of 4d-310 following a single iv administration. the study population is comprised of adult males and females with fabry disease.

this is a prospective multicenter, open-label, dose-escalation trial to assess the safety, tolerability, and pharmacodynamics of 4d-310 following a single iv administration. the study population is comprised of adult males and females with fabry disease.

Eligibility criteria:
inclusion criteria: 1. male or female ≥ 18 years of age 2. pathogenic gla mutation consistent with fabry disease 3. confirmed diagnosis of classic or late-onset fabry disease 4. individuals on ert must be on a stable dose for at least 6 months (and a minimum of 12 months total exposure) prior to study enrollment 5. agree to use highly effective contraception exclusion criteria: 1. presence of high titer neutralizing antibody to 4d-310 capsid, or presence of high antibody titer to aga 2. egfr \<45 ml/min/1.73 m2 3. undergone kidney transplantation or currently on hemodialysis or peritoneal dialysis 4. hiv, active or chronic hepatitis b or c, 5. evidence of liver disease, severe pulmonary disease or diabetes with poor glycemic control 6. history of stroke or transient ischemic attack within the last 12 months, or other significant thromboembolic disease history (e.g. pulmonary embolism) 7. contraindication to systemic corticosteroid therapy or immunosuppressive therapy 8. chronic steroid use, defined as ≥ 3 months of oral corticosteroid use within the last 12 months. 9. moderately severe to severe cardiovascular disease or uncontrolled hypertension 10. left ventricular ejection fraction of \<45% on echocardiogram (echo) 11. currently receiving investigational drug, device or therapy or having ever received gene therapy 12. history of infusion related response to ert or any adverse reaction leading to ert discontinuation 13. history of cancer within 2 years (exceptions include non-melanoma skin cancer, localized prostate cancer treated with curative intent) 14. pregnant or breast-feeding

Keywords: lysosomal storage diseases nervous system brain diseases metabolic inborn brain diseases metabolic brain diseases central nervous system diseases nervous system diseases cerebral small vessel diseases cerebrovascular disorders vascular diseases cardiovascular diseases genetic diseases x-linked inborn metabolic diseases lipid metabolism disorders sphingolipidoses metabolism inborn errors lipidoses lipid metabolism
selective ct for anticoagulated head injured patients

Conditions: Head Injury; Traumatic Brain Injury; Intracranial Hemorrhage, Traumatic; Blunt Head Injury

Summary: the goal is to derive and a clinical decision rule for safe exclusion of traumatic brain injury without neuroimaging in head-injured ed patients who take anticoagulant medications. the objectives are to: 1. derive and externally validate a new highly sensitive and maximally specific clinical decision rule for the exclusion of traumatic brain injury in head-injured ed patients who take anticoagulant medications; and, 2. estimate the sensitivity and specificity of existing head injury clinical decision rules in head-injured ed patients who take anticoagulant medications.

this is a prospective cohort study enrolling 4000 anticoagulated patients presenting with blunt head trauma to the emergency department. emergency physicians will record the presence or absence of clinical predictors for traumatic brain injury at the time of assessment. all patients will undergo head ct scanning and are followed for 30 days. the adjudicated primary outcome is clinically important traumatic brain injury diagnosed at the index ed presentation. the secondary outcome is delayed clinically important traumatic brain injury, diagnosed within 30 days of normal index head ct scan. the primary analysis will be to derive a novel clinical decision rule which excludes clinically important traumatic brain injury diagnosed at the index ed visit. the secondary analyses will include: 1. the diagnostic accuracy of existing head injury clinical decision rules in diagnosing clinically important traumatic brain injury on index ed visit, in patients who take anticoagulation; and, 2. the sensitivity and specificity of the new and existing rules for the diagnosis of both index and delayed clinically important traumatic brain injury.

Eligibility criteria:
inclusion criteria: * age ≥16 years * presents to the emergency department after a head injury * patient has a head ct in the emergency department * is a current anticoagulant user exclusion criteria: * head injury occurred \>48 h before patient's arrival to the emergency department * penetrating head injury * previously enrolled * patient resides outside of the hospital's catchment area * patient was transferred from another emergency department following neuroimaging * patient was not managed by the emergency or trauma physician in the emergency department * leaves the emergency department prior to completion of their medical assessment
a study of trilaciclib combined with chemotherapy in the treatment of nsclc

Conditions: NSCLC

Summary: the aim of this study is to investigate the safety and efficacy of the prophylactic use of trilaciclib in patients with non-small cell lung cancer (nsclc) receiving platinum-based chemotherapy, so as to provide more evidence-based medical evidence for the optimal diagnosis and treatment strategy in this population.

this is a single-arm, exploratory clinical study. eligible patients were treated with trilaciclib before the first cycle of chemotherapy, and their peripheral blood samples were tested on days 3,7,14,21±1 after chemotherapy. at the same time, the incidence of fn, the use of antibiotics, the safety, the number of patients who delayed the second cycle of treatment, the number of patients who reduced the dose of chemotherapy, the number of patients who reduced the dose of chemotherapy due to neutropenia, and the number of patients who discontinued chemotherapy were observed.

Eligibility criteria:
inclusion criteria: * age above 18 years old (including 18 years old)，regardless of gender； * ecog-ps score of 0-1,； * expected survival≥12 weeks； * there was no tumor deterioration in the 2 weeks prior to study drug treatment. * advanced non-small cell lung cancer without systemic chemotherapy. * at least one tumor lesion with a maximum diameter ≥10 mm (short diameter ≥15 mm if it is a lymph node) that could be measured accurately at baseline according to recist1.1 criteria. baseline tumor imaging was performed within 28 days before the first dose. * women of childbearing age should use appropriate contraception and should not breastfeed from screening until 3 months after discontinuation of study treatment. * male subjects should use barrier contraception (i.e., condoms) for 3 months from screening until discontinuation of study treatment. * all subjects voluntarily participated and signed the informed consent form in person. exclusion criteria: * uncontrolled ischemic heart disease or clinically significant congestive heart failure (nyha class iii or iv); * stroke or cardio-cerebrovascular event within 6 months before enrollment; * qtcf interval \> 480msec at screening or \> 500msec for patients with implanted ventricular pacemakers; * previous hematopoietic stem cell or bone marrow transplantation; * allergy to the study drug or its components; * others considered by the investigator to be unsuitable for this study.
volume 3d_us kidney

Conditions: Chronic Kidney Diseases; Renal Tumor

Summary: the purpose of this study is to measure the volume of the kidney and tumors using 3d-us acquisition and to correlate these measurements to contrast-enhanced ct or mri.

additional objectives are comparison between true volume measurements and volume estimation using measurements of the three perpendicular diameters, comparison of inter and intra variability of 3d us measurements with inter and intra variability of 3d ct or mri measurements, calculation of 3d and 2d volume measurements during contrast-enhanced us examination when the injection is performed for clinical routine purposes such as vascular and extension staging, during interventional procedures such as us guided biopsy targeting the non-necrotic tumour parenchyma. concordance between 2d and 3d us acquisitions will be compared to ct and mri measurements. comparison of volume measurements between non-contrast and contrast-enhanced methods (us, ct and mri) will be performed. the results will be compared to renal function before and after tumour treatment.

Eligibility criteria:
inclusion criteria: * adult patient (age 18) * absence of participant's opposition * no contra-indication to contrast-enhanced ct and mri (a single contrast-enhanced imaging modality is sufficient) * affiliated to social security exclusion criteria: - contra-indication to both contrast-enhanced ct and mri

Keywords: 3d ultrasound volume measurements renal volume tumour volume
osteopathic approach in inflammatory bowel diseases

Conditions: Inflammatory Bowel Diseases (IBD)

Summary: crohn's disease (cd) and ulcerative colitis are bowel disease (ibs) with an autoimmune component believed to affect approximately 1 in 140 canadians. despite this high prevalence, more than 30% patients with ibd have to live with recurrent gastrointestinal symptoms that is poorly relieved by allopathic medicine. numerous studies have shown that the quality of life of individuals with ibs is lower than that of the general population. since visceral manipulations have been shown to be effective in reducing the main discomforts associated with ibs during clinical interventions, it seems likely that it may provide similar relief to patients with ibd. to our best knowledge, no study has evaluated the impact of osteopathic manual therapy on neuro-immuno-vascular modulation of intestine to reduce ibs symptoms. the aim of this study is to assess the relevance of an osteopathic approach addressing the brain-intestine axis in order to improve symptomatology in subject suffering from ibd by modulating inflammation and vagal tone.

for this study, 10 to 12 participant (18 to 65 years) with inflammatory bowel disease (in remission state) will be recruited to receiving visceral osteopathic therapy. participant will received four standardized osteopathic session of 45 minutes (1 session every 7 days: week 0, 1, 2 and 3) and a follow up visit at week 4. the osteopathic protocol will specifically address the gut-to-brain neuro-immuno-vascular axis. global quality of life and severity of ibs-like symptoms will be a assess at week 0, 2 and 4 using three standardized questionnaires. gut permeability and intestinal inflammation will be assessed at week 0 and 4 by measuring zonulin (pre-haptoglobin 2), histamine and diamine oxidase (do) levels respectively. vagal tone at the beginning and at the end of each osteopathic session will be evaluate using heart rate variability (hrv) measurements.

Eligibility criteria:
inclusion criteria: * subjects diagnosed with inflammatory bowel disease (ibd) in remission state; * subjects must suffer form recurrent digestive symptoms fulfilling the rome iii criteria; * subjects' eating habits should be stable prior to the study. exclusion criteria: * concomitant diagnosis of celiac disease or multiple food intolerance; * concomitant diagnosis of rheumatologic disease; * obesity (bmi ≥ 30); * concomitant diagnosis of severe depression or severe anxiety; * unstable thyroid or kidney condition; * subjects on antidepressant, anti-inflammatory (steroids) or analgesic (paracetamol, aspirin) will be excluded from the study; * smokers, patients with problematic alcohol consumption or consuming drugs will be excluded from the study; * high performance athletes will be excluded from the study.